Experience with HCA/ICC

[fiznat]

Hello all,

I am considering some options for my first job out of fellowship, and one of the opportunities I am seriously considering is though ICC (Intensive Care Consortium) which is a subsidiary of HCA.

I understand HCA has a bit of a poor reputation as they are highly metrics driven and many say they are not particularly physician friendly, but I don't know anyone personally who actually works for ICC. I am hoping someone can help me better understand what being employed by ICC as an intensivist is like, and perhaps share some experiences and (ideally) employment contract comparisons. I like the job a lot from what I've seen so far, but I was hoping to get some more perspectives if possible.

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[chocomorsel]

$180 - $200 an hour, terrible benefits, no vacation, one week on one week off. If you join their travel team you will make slightly more. I almost signed a contract two weeks ago.

 

[grt398]

I know this isn't a direct answer, but it depends a lot on your geographic requirements. Certain metro areas HCA/Sound/Envision seem to have a lockdown on the hospitals. If that's the case, and it's very important to you to be in that area for personal reasons, the rest may not matter. If not, there are a lot of other options nationwide that pay more, with better benefits, paid time off etc. The more rural you go (~1-2 hours driving from major cities) the better your options will be.

That said, always make sure you see what the termination clause is in the contract, especially if you're accepting any type of upfront payment with an amortization schedule. Worst case scenario the job turns out to be terrible, you give your official notice, and 90 days later (or whatever it is in your contract) you start a locums gig for way more money per hour until you find something more acceptable. These days you could literally do 8-10 locums shifts/month (if you're willing to go anywhere for those shifts) and earn a similar income to what many full time jobs will pay you for 15 shifts/month. So even if you have a family you don't want to be away from, you could be home 24/7 for almost 3 weeks of the month...something to consider.

 

[CCM-MD]

I had a friend that signed ICC couple of years ago in Miami for $200/h + benefits. Idk if he is getting paid more now. He was busy but didn't seem unhappy.

I wish these damn corporate groups would gtfo.

 

[psychbender]

Did prn with them a few years ago at one site. Found out I was getting low-balled at $200/hr, the other locums were there for $225/hr. Very busy, I routinely covered over 20 patients solo. Their EMR is also absolutely terrible.

 

[Katheudontas parateroumen]

I'm looking at another corporation like Team Health. Any info on them? Are these rates negotiable for employed positions? It's a job in ideal location for me. Only sees 6 or so pt's per day and then a little telemedicine covering a couple hospitals; on average 14 shifts per month; for $180/hr + estimated $25/hr RVU/production according to them. I believe the going rate is probably base <$225/hr around my area from what I've seen advertised at least. Looking for my first attending job!

 

[CCM-MD]

I'm looking at another corporation like Team Health. Any info on them? Are these rates negotiable for employed positions? It's a job in ideal location for me. Only sees 6 or so pt's per day and then a little telemedicine covering a couple hospitals; on average 14 shifts per month; for $180/hr + estimated $25/hr RVU/production according to them. I believe the going rate is probably base <$225/hr around my area from what I've seen advertised at least. Looking for my first attending job!

Probably won't budge on the rates but no harm trying. Easier to ask for a larger sign on bonus.

 

[chessknt]

I'm looking at another corporation like Team Health. Any info on them? Are these rates negotiable for employed positions? It's a job in ideal location for me. Only sees 6 or so pt's per day and then a little telemedicine covering a couple hospitals; on average 14 shifts per month; for $180/hr + estimated $25/hr RVU/production according to them. I believe the going rate is probably base <$225/hr around my area from what I've seen advertised at least. Looking for my first attending job!

Telemedicine during the day? Billable?

 

[Katheudontas parateroumen]

Telemedicine during the day? Billable?

i didn't know to ask. I guess I will now. They said 8 hrs in house then 3-7pm telemed. I don’t really understand why they would split times like that. Any thoughts? Night is covered by another telemed. Honestly job sounds too good?

 

[CCM-MD]

i didn't know to ask. I guess I will now. They said 8 hrs in house then 3-7pm telemed. I don’t really understand why they would split times like that. Any thoughts? Night is covered by another telemed. Honestly job sounds too good?

Do you get the full hourly pay until 7PM? And "Telemed" as in, you are just covering your own unit remotely from 3pm-7pm? If so, that can be a pretty sweet set up.

 

[chessknt]

i didn't know to ask. I guess I will now. They said 8 hrs in house then 3-7pm telemed. I don’t really understand why they would split times like that. Any thoughts? Night is covered by another telemed. Honestly job sounds too good?

What happens if there is an admit or someone starts doing poorly and needs hands on care?

 

[NontradICUdoc]

I never heard good things about team health

 

[chocomorsel]

Just throwing some sauce in the mix here. Texted a friend of mine, an ICU PA who does locums. He’s currently in SC at some small town one week on and week off making $185 per hour. Saw a Reddit post about a CRNA making $175 an hour for full time work.
Just putting it out here as some of us go for these paltry salaries. Do some locums if you can one week a month and then maybe pick up some local shifts. Don’t take those rates if you can.
Sucks how docs get shafted and ask for more. We gotta be aggressive. I refuse to work for those numbers. Got offered $180 in my town for anesthesia and almost did it on my off weeks then was like, nope, midlevel pay.

 

[CCM-MD]

Just throwing some sauce in the mix here. Texted a friend of mine, an ICU PA who does locums. He’s currently in SC at some small town one week on and week off making $185 per hour. Saw a Reddit post about a CRNA making $175 an hour for full time work.
Just putting it out here as some of us go for these paltry salaries. Do some locums if you can one week a month and then maybe pick up some local shifts. Don’t take those rates if you can.
Sucks how docs get shafted and ask for more. We gotta be aggressive. I refuse to work for those numbers. Got offered $180 in my town for anesthesia and almost did it on my off weeks then was like, nope, midlevel pay.

Agreed. I think if more of us do locums instead of taking these ****ty gigs, the permanent market might improve… though the locum market might worsen but idc as much about that.

 

[chocomorsel]

Agreed. I think if more of us do locums instead of taking these ****ty gigs, the permanent market might improve… though the locum market might worsen but idc as much about that.

The market wouldn’t worsen. Because the permanent need would only go up since docs are leaving permanent jobs and leaving holes in the schedule.
Either that or negotiate better rates. But since it’s corporate then it likely won’t work.
I work for Envision as a PRN and let me tell you, the untrained ER docs covering the ICUs make more than me. Because they are given their ER rates.
It used to be $225 an hour and I complained that it is BS that the ER, non fellowship docs made way more than that and don’t have a clue. Now it’s $275 like the smaller Envision sites. I am sure I am not the only one who brought it up or at least I hope.

 

[The kitchen sink]

The market wouldn’t worsen. Because the permanent need would only go up since docs are leaving permanent jobs and leaving holes in the schedule.
Either that or negotiate better rates. But since it’s corporate then it likely won’t work.
I work for Envision as a PRN and let me tell you, the untrained ER docs covering the ICUs make more than me. Because they are given their ER rates.
It used to be $225 an hour and I complained that it is BS that the ER, non fellowship docs made way more than that and don’t have a clue. Now it’s $275 like the smaller Envision sites. I am sure I am not the only one who brought it up or at least I hope.

$275 is the per diem ICU rate ?

Right now im doing locums CC shifts for >$350/hr. It certainly won’t last but I’m going to cash in.

As an aside, how did the ER folks negotiate better rates? Arguably you are stabilizing much sicker patients from the floors and ER, and taking on way more liability as a CC doc. At some places, the ER will start pts on peripheral pressors and send the pt to the ICU. Usually the CC teams are the ones placing all the crash lines in the hospital. Although some places do have surgical residents or PAs doing crash lines and anesthesia intubating.

Point is, why are the rates so variable for us while stable for the ER ppls?

Should we start our own union, or can SCCM do anything about this?

Curious to hear opinions. Thanks

 

[chocomorsel]

$275 is the per diem ICU rate ?

Right now im doing locums CC shifts for >$350/hr. It certainly won’t last but I’m going to cash in.

As an aside, how did the ER folks negotiate better rates? Arguably you are stabilizing much sicker patients from the floors and ER, and taking on way more liability as a CC doc. At some places, the ER will start pts on peripheral pressors and send the pt to the ICU. Usually the CC teams are the ones placing all the crash lines in the hospital. Although some places do have surgical residents or PAs doing crash lines and anesthesia intubating.

Point is, why are the rates so variable for us while stable for the ER ppls?

Should we start our own union, or can SCCM do anything about this?

Curious to hear opinions. Thanks

The ER docs get what they get because that is the ER rate. Apparently it's better than the ICU rate here in my city. So it's just like picking up extra shifts except not in the ER.
I have a FT job so this is my 1099 that I do on the side that pays the $275 and it's in my town and I don't have to fly anywhere.

 

[The kitchen sink]

The ER docs get what they get because that is the ER rate. Apparently it's better than the ICU rate here in my city. So it's just like picking up extra shifts except not in the ER.
I have a FT job so this is my 1099 that I do on the side that pays the $275 and it's in my town and I don't have to fly anywhere.

$275 isn’t bad. We should go no lower than $250 imo, and $225 ONLY if it is ‘lighter’ work i.e. smaller community ICUs with low volume and no call. Just my opinion, but realistically $250 and above is where I think we need to start.

 

[chocomorsel]

$275 isn’t bad. We should go no lower than $250 imo, and $225 ONLY if it is ‘lighter’ work i.e. smaller community ICUs with low volume and no call. Just my opinion, but realistically $250 and above is where I think we need to start.

I think we need to start at $300 IMO. I will wait a little and then bump up my rate and see what they say. Occasionally when they are desperate they give time and half.

 

[The kitchen sink]

I think we need to start at $300 IMO. I will wait a little and then bump up my rate and see what they say. Occasionally when they are desperate they give time and half.

You’re right. Disregard my prior thread. $300+. I was only considering $225 at this really tiny small shop. But they didnt even want to go past $185. This was per diem W2 rates. Anyway im getting the rates I want now via locums. So for now, I’ll only do locums.

 

[fiznat]

How successful have you folks been in negotiating these rates up? The corporate shop I’m looking at wants to pay $210/hr for probably 15-18 patients/day, 15 shifts/month, and split nights among 6 docs. There are fellows and residents which I imagine will be protective somewhat. I suggested a little higher on the hourly but they’re balking.

 

[chocomorsel]

How successful have you folks been in negotiating these rates up? The corporate shop I’m looking at wants to pay $210/hr for probably 15-18 patients/day, 15 shifts/month, and split nights among 6 docs. There are fellows and residents which I imagine will be protective somewhat. I suggested a little higher on the hourly but they’re balking.

Be willing and able to walk. That’s the best way to negotiate. If you are stuck then they can screw you as much as they want.
Is it possible for you to travel one week a month and work for the corporate overloads the rest the month?

 

[The kitchen sink]

How successful have you folks been in negotiating these rates up? The corporate shop I’m looking at wants to pay $210/hr for probably 15-18 patients/day, 15 shifts/month, and split nights among 6 docs. There are fellows and residents which I imagine will be protective somewhat. I suggested a little higher on the hourly but they’re balking.

You’re feet will determine you’re success i.e. willingness to walk away.

 

[Katheudontas parateroumen]

Back with some more info. This is just information through a recruiter through email.

$180/hr + production RVU/quality bonus for 8 hours on-site then 4 hours of telemedicine at $45/hr. Average up to 6 patients per day. No night shifts.

I know it sounds super low ball but is that what could be expected out of such a low volume place with 6 patients per day? Also, what is a quality bonus mean usually?

I’m mostly using this job as an example of what I should be looking for. Thank you so much so far for the help and guidance!

 

[chessknt]

Back with some more info. This is just information through a recruiter through email.

$180/hr + RVU/quality bonus for 8 hours on-site then 4 hours of telemedicine at $45/hr. Only up to 6 patients per day. No night shifts.

I know it sounds super low ball but is that what could be expected out of such a low volume place with 6 patients per day? Also, what is a quality bonus mean usually?

I’m mostly using this job as an example of what I should be looking for. Thank you so much so far for the help and guidance!

How is rvu bonus structured? 6 pts per day you aren’t going to be earning much unless it is very generous..

Also 6 pts per day skills might get rusty.

Telemedicine setup honestly sounds like a way to cheap out on the shift. 6 pts and off the hook for admits you should be easily done before 8 hours and if you go home and cover phone calls like a Hospitalist that is fine but they apparently want to cut your rate and maybe squeeze more out of you during your home time (unless the telemedicine is just what they’re calling you covering your own patients and not some ridiculous number.

 

[The kitchen sink]

Back with some more info. This is just information through a recruiter through email.

$180/hr + production RVU/quality bonus for 8 hours on-site then 4 hours of telemedicine at $45/hr. Average up to 6 patients per day. No night shifts.

I know it sounds super low ball but is that what could be expected out of such a low volume place with 6 patients per day? Also, what is a quality bonus mean usually?

I’m mostly using this job as an example of what I should be looking for. Thank you so much so far for the help and guidance!

Recruiter is skimming off the top. Negotiate directly with the hospital.

 

[chessknt]

Recruiter is skimming off the top. Negotiate directly with the hospital.

Too late, once a recruiter introduces you they are getting a commission if you are hired there. Gotta look at the ad then go direct to the hospital without ever contacting the recruiter

 

[fiznat]

Too late, once a recruiter introduces you they are getting a commission if you are hired there. Gotta look at the ad then go direct to the hospital without ever contacting the recruiter

Yup, I fired my recruiter earlier in the process when I learned this. One of the jobs I was looking at mentioned that they paid the damn recruiter a $30k finder fee which is why my sign on bonus couldn’t be more. Screw that. She wasn’t finding me anything special anyway, and always seemed to be pushing me towards jobs I didn’t want (likely high bonuses for her). I found a good job without her and I’m glad she wasn’t involved. Parasites.

 

[The kitchen sink]

Yup, I fired my recruiter earlier in the process when I learned this. One of the jobs I was looking at mentioned that they paid the damn recruiter a $30k finder fee which is why my sign on bonus couldn’t be more. Screw that. She wasn’t finding me anything special anyway, and always seemed to be pushing me towards jobs I didn’t want (likely high bonuses for her). I found a good job without her and I’m glad she wasn’t involved. Parasites.

Why don’t hospitals realize that recruiters are parasites?

Or are they just attracted to administrative scum like themselves?